eMedicine Specialties > Physical Medicine and Rehabilitation > Lower Limb Musculoskeletal Conditions

Iliotibial Band Syndrome: Follow-up

Author: John M Martinez, MD, Medical Director, Primary Care Sports Medicine, Coastal Sports and Wellness Medical Center
Coauthor(s): Kenneth Honsik, MD, Consulting Staff, Department of Primary Care Sports Medicine, Kaiser Permanente; Consuelo T Lorenzo, MD, Consulting Staff, Department of Physical Medicine and Rehabilitation, Alegent Health Care, Immanuel Rehabilitation Center
Contributor Information and Disclosures

Updated: Apr 17, 2009

Follow-up

Further Outpatient Care

  • The patient should continue physical therapy until the symptoms of iliotibial band syndrome improve or he/she can continue the exercises independently. See Physical Therapy for treatment recommendations.

Inpatient & Outpatient Medications

  • The patient with iliotibial band syndrome is treated as an outpatient with medications that include NSAIDs or corticosteroid injections, as discussed above (see Medication).

Transfer

  • Transfer of care (referral) is warranted if the patient's symptoms do not improve with conservative management.

Deterrence

  • The key to preventing iliotibial band syndrome (ITBS) is having a well-balanced approach to training. Runners need to limit their uphill/downhill training and to run on level surfaces as much as possible. When training on a track, it is important to alternate the direction of running from clockwise to counterclockwise regularly to avoid repetitive stress to 1 leg. Preventative stretching of the ITB and gluteals also is important. Individuals with known subtalar joint hyperpronation may occasionally avoid developing ITBS by wearing proper shoes and orthotics to correct faulty biomechanics.

Complications

  • Complications of iliotibial band syndrome (ITBS) can include continued pain and an inability to maintain a training program. Some patients may demonstrate significant biomechanical abnormalities of the lower extremity as they attempt to compensate for ITBS-related pain.

Prognosis

  • Prognosis for iliotibial band syndrome is very good with the appropriate treatment.

Patient Education

  • Education is important in preventing recurrence of iliotibial band syndrome (ITBS).
  • Education should focus on instructing the patient in proper stretching techniques, as well as on educating patients about the use of ice and NSAIDs for minor irritation or inflammation of the ITB.
  • More importantly, the patient should learn to recognize symptoms that indicate when training volume should be decreased and when training surfaces should be changed.

Miscellaneous

Medicolegal Pitfalls

  • Misdiagnosing a more severe knee condition, such as femoral rhabdomyosarcoma, as iliotibial band syndrome results in a subsequent delay of appropriate treatment.
 


More on Iliotibial Band Syndrome

Overview: Iliotibial Band Syndrome
Differential Diagnoses & Workup: Iliotibial Band Syndrome
Treatment & Medication: Iliotibial Band Syndrome
Follow-up: Iliotibial Band Syndrome
Multimedia: Iliotibial Band Syndrome
References
Further Reading
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References

  1. Fredericson M, Weir A. Practical management of iliotibial band friction syndrome in runners. Clin J Sport Med. May 2006;16(3):261-8. [Medline].

  2. Fredericson M, Wolf C. Iliotibial band syndrome in runners: innovations in treatment. Sports Med. 2005;35(5):451-9. [Medline].

  3. Hamill J, Miller R, Noehren B, Davis I. A prospective study of iliotibial band strain in runners. Clin Biomech (Bristol, Avon). Oct 2008;23(8):1018-25. [Medline].

  4. Grau S, Maiwald C, Krauss I, Axmann D, Horstmann T. The influence of matching populations on kinematic and kinetic variables in runners with iliotibial band syndrome. Res Q Exerc Sport. Dec 2008;79(4):450-7. [Medline].

  5. Khaund R, Flynn SH. Iliotibial band syndrome: a common source of knee pain. Am Fam Physician. Apr 15 2005;71(8):1545-50. [Medline]. [Full Text].

  6. Grau S, Krauss I, Maiwald C, et al. Hip abductor weakness is not the cause for iliotibial band syndrome. Int J Sports Med. Jul 2008;29(7):579-83. [Medline].

  7. Ilizaliturri VM Jr, Martinez-Escalante FA, Chaidez PA, et al. Endoscopic iliotibial band release for external snapping hip syndrome. Arthroscopy. May 2006;22(5):505-10. [Medline].

  8. Hariri S, Savidge ET, Reinold MM, Zachazewski J, Gill TJ. Treatment of recalcitrant iliotibial band friction syndrome with open iliotibial band bursectomy: indications, technique, and clinical outcomes. Am J Sports Med. Mar 13 2009;[Medline].

  9. Michels F, Jambou S, Allard M, Bousquet V, Colombet P, de Lavigne C. An arthroscopic technique to treat the iliotibial band syndrome. Knee Surg Sports Traumatol Arthrosc. Mar 2009;17(3):233-6. [Medline].

  10. Adams WB. Treatment options in overuse injuries of the knee: patellofemoral syndrome, iliotibial band syndrome, and degenerative meniscal tears. Curr Sports Med Rep. Oct 2004;3(5):256-60. [Medline].

  11. Biundo JJ Jr, Irwin RW, Umpierre E. Sports and other soft tissue injuries, tendinitis, bursitis, and occupation-related syndromes. Curr Opin Rheumatol. Mar 2001;13(2):146-9. [Medline].

  12. Brosseau L, Casimiro L, Milne S. Deep transverse friction massage for treating tendinitis. Cochrane Database Syst Rev. 2002;CD003528. [Medline].

  13. Faraj AA, Moulton A, Sirivastava VM. Snapping iliotibial band. Report of ten cases and review of the literature. Acta Orthop Belg. Feb 2001;67(1):19-23. [Medline].

  14. Fredericson M, Cookingham CL, Chaudhari AM. Hip abductor weakness in distance runners with iliotibial band syndrome. Clin J Sport Med. Jul 2000;10(3):169-75. [Medline].

  15. Garrick JG, Webb DR. Sports Injuries. Diagnosis and Management. Philadelphia, Pa: WB Saunders; 1999.

  16. Jones RL. The injured or painful knee and its evaluation. In: Clinics in Family Medicine. 1999 Dec:209.

  17. Kendal FP, et al. Muscles: Function and Testing. 4th ed. Baltimore, Md: Williams & Wilkins; 1993.

  18. Noble CA. The treatment of iliotibial band friction syndrome. Br J Sports Med. Jun 1979;13(2):51-4. [Medline]. [Full Text].

  19. Sutker AN, Barber FA, Jackson DW, Pagliano JW. Iliotibial band syndrome in distance runners. Sports Med. Nov-Dec 1985;2(6):447-51. [Medline].

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Keywords

iliotibial band syndrome, hip pain, iliotibial band, iliotibial, IT band, ITBS, iliotibial syndrome, running injury, IT band syndrome, pain in hip, IT band pain, greater trochanter, ITB syndrome, lateral femoral condyle, IT band stretch, iliotibial band friction syndrome, IT band knee, overuse injury, iliotibial band tendonitis, trochanteric bursitis, lateral knee pain

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Contributor Information and Disclosures

Author

John M Martinez, MD, Medical Director, Primary Care Sports Medicine, Coastal Sports and Wellness Medical Center
John M Martinez, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, and American Medical Society for Sports Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Kenneth Honsik, MD, Consulting Staff, Department of Primary Care Sports Medicine, Kaiser Permanente
Disclosure: Nothing to disclose.

Consuelo T Lorenzo, MD, Consulting Staff, Department of Physical Medicine and Rehabilitation, Alegent Health Care, Immanuel Rehabilitation Center
Consuelo T Lorenzo, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation
Disclosure: Nothing to disclose.

Medical Editor

Robert E Windsor, MD, FAAPMR, FAAEM, FAAPM, President and Director, Georgia Pain Physicians, PC; Clinical Associate Professor, Department of Physical Medicine and Rehabilitation, Emory University School of Medicine
Robert E Windsor, MD, FAAPMR, FAAEM, FAAPM is a member of the following medical societies: American Academy of Pain Medicine, American Academy of Physical Medicine and Rehabilitation, American College of Sports Medicine, American Medical Association, International Association for the Study of Pain, Physiatric Association of Spine, Sports and Occupational Rehabilitation, and Texas Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Michael T Andary, MD, MS, Residency Program Director, Professor, Department of Physical Medicine and Rehabilitation, Michigan State University College of Osteopathic Medicine
Michael T Andary, MD, MS is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American Medical Association, and Association of Academic Physiatrists
Disclosure: allergan Honoraria Speaking and teaching; Pfizer Honoraria Speaking and teaching

CME Editor

Kelly L Allen, MD, Regional Medical Director, IMX-Medical Management Services
Disclosure: Nothing to disclose.

Chief Editor

Rene Cailliet, MD, Professor-Chairman Emeritus, Department of Rehabilitation Medicine, University of Southern California School of Medicine; Former Director, Department of Rehabilitation Medicine, Santa Monica Hospital Medical Center
Rene Cailliet, MD is a member of the following medical societies: American Academy of Pain Medicine, American Academy of Physical Medicine and Rehabilitation, American Pain Society, Association of American Medical Colleges, International Association for the Study of Pain, and Pan American Medical Association
Disclosure: Nothing to disclose.

 
 
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